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General NPI Number Information
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NPI Number | 1285735837
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Entity Type | Organization
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Legal Business Name | LUCIEN L JOHNSON M D INC
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 07/20/2011
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Provider Practice Location Address
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Address Line | 3756 SANTA ROSALIA DR SUITE 422
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City | LOS ANGELES
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State | CA
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Zip | 90008-3606
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Country | US
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Telephone | 323-292-0211
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Fax |
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Provider Business Mailing Address
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Address Line | 3756 SANTA ROSALIA DR SUITE 422
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City | LOS ANGELES
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State | CA
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Zip | 90008-3606
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Country | US
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Telephone | 323-292-0211
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Fax |
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Authorized Official
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Title or Position | BILLER
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Name | MS. HAZARA GRIER
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Credential |
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Telephone | 310-330-0074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State | CA
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